RT Journal Article
SR Electronic
T1 The role of vitamin D supplementation in the risk of developing pneumonia: three independent case–control studies
JF Thorax
JO Thorax
FD BMJ Publishing Group Ltd and British Thoracic Society
SP 990
OP 996
DO 10.1136/thoraxjnl-2013-203623
VO 68
IS 11
A1 Hilde H F Remmelts
A1 Simone M C Spoorenberg
A1 Jan Jelrik Oosterheert
A1 Willem Jan W Bos
A1 Mark C H de Groot
A1 Ewoudt M W van de Garde
YR 2013
UL http://thorax.bmj.com/content/68/11/990.abstract
AB Background Vitamin D plays a role in host defence against infection. Vitamin D deficiency has been associated with an increased risk of respiratory tract infections in children and adults. This study aimed to examine whether vitamin D supplementation is associated with a lower pneumonia risk in adults. Methods Three independent case–control studies were performed including a total of 33 726 cases with pneumonia in different settings with respect to hospitalisation status and a total of 105 243 controls. Cases and controls were matched by year of birth, gender and index date. The major outcome measure was exposure to vitamin D supplementation at the time of pneumonia diagnosis. Conditional logistic regression was used to compute ORs for the association between vitamin D supplementation and occurrence of pneumonia. Results Vitamin D supplementation was not associated with a lower risk of pneumonia. In studies 1 and 2, adjustment for confounding resulted in non-significant ORs of 1.814 (95% CI 0.865 to 3.803) and 1.007 (95% CI 0.888 to 1.142), respectively. In study 3, after adjustment for confounding, the risk of pneumonia remained significantly higher among vitamin D users (OR 1.496, 95% CI 1.208 to 1.853). Additional analyses showed significant modification of the association through co-use of corticosteroids and drugs that affect bone mineralisation. For patients using these drugs, ORs below one were found combined with higher ORs for patients not using these drugs. Conclusions This study showed no preventive association between vitamin D supplementation and the risk of pneumonia in adults.